# 11 NYCRR 65-3.16: Measurement of no-fault benefits

- Part of: 11 NYCRR Subpart 65-3 (Insurance Regulation 68-C), Claims for Personal Injury Protection Benefits; 11 NYCRR Part 65 (Insurance Regulation 68)
- Page: https://www.beynensonlaw.com/no-fault-regulations/11-nycrr-65-3-16/
- Source: New York State Department of Financial Services, https://www.dfs.ny.gov/system/files/documents/2024/08/reg68_11_nycrr_65_full_txt.pdf (retrieved 2026-10-04)
- Checked against the Department's list of amendments through 2026-10-04
- Unofficial copy. The official compilation is the New York Codes, Rules and Regulations (NYCRR).
- Each provision below starts with its full path, so (a)(2) is paragraph (2) of subdivision (a). Stable IDs have the form `11nycrr:65-3.16(a)(2)`.

## Text

(a) Medical expenses. (1) Payment for medical expenses shall be in accordance with fee schedules promulgated under section 5108 of the Insurance Law and contained in Part 68 of this Title (Regulation 83).

(a)(2) Where an applicant receives treatment from a health maintenance organization, an Insurance Law article 43 corporation, a veterans administration hospital or provider, or any other provider which does not render specific charges for services, or where any such charges are indeterminate, the applicant shall be entitled to payment of benefits equal to the value for equivalent services rendered by a provider as limited by section 5108 of the Insurance Law and Part 68 of this Title (Regulation 83).

(a)(3) Pursuant to section 5102(a)(1) of the Insurance Law, an insurer shall not be liable for the payment of medical and other benefits enumerated in section 5102(a)(1) of the Insurance Law if, during a period of one year from the date of the accident, no such expenses have been incurred by the applicant.

(a)(4) The term nursing, as used in section 5102(a)(1)(i) of the Insurance Law, shall include but not be limited to all necessary services rendered to the eligible injured person by a licensed practical nurse.

(a)(5) If the applicant’s injuries warrant occupational therapy or rehabilitation based on an attending physician’s recommendation, or if the injuries have rendered the applicant unable to resume the applicant’s occupation, the insurer shall inform the applicant of the coverage for occupational therapy or rehabilitation required by section 5102(a)(1)(ii) of the Insurance Law, and the insurer shall assist the applicant in obtaining such occupational therapy and rehabilitation.

(a)(6) The term any other professional health services, as used in section 5102(a)(1)(iv) of the Insurance Law, this Part and approved endorsements, shall be limited to those services that are required or would be required to be licensed by the State of New York if performed within the State of New York. Such professional health services should be necessary for the treatment of the injuries sustained and within the lawful scope of the licensee’s practice. Charges for the services shall be covered pursuant to schedules promulgated under section 5108 of the Insurance Law and Part 68 of this Title (Regulation 83). The services need not be initiated through referral by a treating or practicing physician.

(a)(7) The scope of the term religious methods of healing recognized by the laws of this State, as used in section 5102(a)(1)(iii) of the Insurance Law, this Part and approved endorsements, is a method recognized under article 131 of the Education Law. Charges for such services shall be covered pursuant to schedules promulgated under section 5108 of the Insurance Law.

(a)(8) Services rendered to the eligible injured person by a certified or licensed home health care agency shall be considered a medical expense payable under section 5102(a)(1) of the Insurance Law.

(a)(9) Pursuant to section 5102(b)(2) of the Insurance Law, when the applicant is entitled to workers’ compensation benefits due to the same accident, the workers’ compensation carrier shall be the sole source of reimbursement for medical expenses.

(a)(10) If a provider of health service requires proof of the applicant’s ability to pay for the services to be rendered as a result of the accident, the insurer shall provide the applicant or the provider (if the applicant is entitled to benefits) with a letter stating that the applicant has coverage under its policy and that the necessary medical expenses incurred as a result of the accident are covered expenses subject to the policy limits and conditions and applicable fee schedules.

(a)(11) Within 30 calendar days of a submission by a dentist or plastic surgeon of a proposal for a course of treatment and charges, an insurer shall review such proposal and notify the provider as to whether or not payment will be made in accordance with the proposal. The foregoing shall apply to nonemergency situations and when the course of treatment is expected to involve covered expenses of $250 or more.

(a)(12) A provider of health care services is not eligible for reimbursement under section 5102(a)(1) of the Insurance Law if the provider fails to meet any applicable New York State or local licensing requirement necessary to perform such service in New York or meet any applicable licensing requirement necessary to perform such service in any other state in which such service is performed.

(b) Loss of earnings. In determining loss of earnings from work:

(b)(1) benefits from other sources shall not be considered as an offset against or a deduction from loss of earnings, unless article 51 of the Insurance Law expressly provides for such offset or deduction;

(b)(1)(i) within the meaning of section 5102(a)(2) of the Insurance Law, insurers shall not take a deduction for statutory or contractual wage continuation plans which are diminished or exhausted as payments are made or when accumulated sick leave time is used. In order for an insurer to be entitled to offset or deduct payments received by a claimant under a particular wage continuation plan, the plan must meet all of the following conditions:

(b)(1)(i)(a) the applicant must be entitled to receive the same level of wage continuation benefits for a subsequent unrelated accident or illness when he or she returns to work after recovering from the injuries sustained in the motor vehicle accident;

(b)(1)(i)(b) benefits for a subsequent unrelated accident or illness must be equal in both time and amount to the wage continuation benefits to which the applicant was entitled as a result of the injuries suffered in the motor vehicle accident; and

(b)(1)(i)(c) wage continuation benefits for a subsequent disability must be immediately available, without any requirement that the applicant work a stated period of time before full benefits are restored;

(b)(1)(ii) within the meaning of section 5102(a)(2) of the Insurance Law, insurers shall take a deduction for any payments made by an employer on a voluntary basis;

(b)(1)(iii) within the meaning of section 5102(a)(2) of the Insurance Law, insurers shall not take a deduction for contractual or voluntary long-term disability plans, which generally become effective six months after the date disability begins;

(b)(2) insureds covered by wage continuation plans which meet the criteria for deduction set forth in subparagraph (1)(i) of this subdivision, are entitled to a premium reduction to reflect the insurer’s reduced exposure to loss, pursuant to section 2330 of the Insurance Law. Insurers shall grant the premium reduction upon receipt of information that indicates the insured is covered by such wage continuation plan;

(b)(3) loss of earnings from work shall not necessarily be limited to the applicant’s actual level of earnings at the time of the accident, but may also include demonstrated future earnings reasonably projected;

(b)(4) an applicant, whose unemployment was the result of the seasonal nature of the work which the applicant usually performed, shall be entitled to receive payments for loss of earnings from work during the claimed period of disability arising from the accident which coincides with the seasonal period of employment;

(b)(5) where the injury renders an unemployed applicant ineligible to receive unemployment benefits, the applicant shall be entitled to receive payments for loss of earnings from work equivalent in value to the unemployment benefits which the applicant would otherwise have received. If an unemployed applicant is eligible for disability benefits pursuant to Workers’ Compensation Law, section 207 (sick unemployed fund), the no-fault insurer shall supplement such benefits to bring them up to the level of the lost unemployment benefits. If the unemployed applicant is not eligible for such disability benefits, the insurer shall pay an amount equal to the lost unemployment benefits. Such loss of earnings is eligible basic economic loss, but is not subject to the 20-percent offset from loss of earnings provided for in section 5102(b)(1) of the Insurance Law;

(b)(6) if the applicant, while disabled, is discharged from employment solely because of inability to work due to the injury, benefits for basic economic loss shall continue at the same level while the disability continues;

(b)(7) if an applicant, while disabled, is discharged from employment, benefits shall cease if the position would have been lost had the accident not occurred (e.g., plant shutdown, strike, etc.). However, the insurer shall reimburse the applicant for benefits lost which would have been received had the applicant not been disabled (e.g., union strike benefits, unemployment, etc.);

(b)(8) during the continuance of a disability arising from a covered accident, loss of earnings benefits due and payable must be paid periodically, at least once in every 30 calendar days;

(b)(9) refusal by an eligible injured person to accept reasonable rehabilitative treatment may be the basis for denial of future payment of benefits for loss of earnings from work and may be used as evidence to dispute the reasonableness or necessity of any further expense or loss;

(b)(10) substitute services:

(b)(10)(i) where an applicant sustains expenses in obtaining services in lieu of those such person would have performed for income, but still suffers a net loss of earnings from work which the applicant would have performed, such loss of earnings is eligible basic economic loss and shall be subject to the offsets provided for in section 5102(b) of the Insurance Law; and the cost of substitute services reasonably sustained is also eligible basic economic loss, but shall not be subject to such offsets;

(b)(10)(ii) where an applicant has a claim for both substitute services and loss of earnings from work, the claim for substitute services shall be primary in computing the loss of earnings benefit payable;

(b)(11) monthly work loss limit. The monthly limitation on the aggregate of work loss and substitute services shall not be prorated in the event that one is unable to work or is required to obtain substitute services for a period less than one month. A month shall be each consecutive period of 30 days beginning with the date of the accident unless the injury extends for more than one year, in which case there shall be 12 monthly payment periods for the period from the date of accident to each annual anniversary of the accident date;

(b)(12) the maximum first-party benefit payable for loss of earnings from work under the mandatory coverage is $1,000 per month for claims arising from accidents occurring prior to November 12, 1991 and $2,000 per month for claims arising from accidents occurring on and after November 12, 1991;

(b)(13) lump-sum settlement for loss of earnings:

(b)(13)(i) an insurer may at its option enter into a lump-sum settlement agreement for the payment of first-party benefits, provided that competent medical testimony establishes that:

(b)(13)(i)(a) the period of disability will extend for at least three years beyond the date of the accident; and

(b)(13)(i)(b) the settlement would be of material benefit to the applicant, occupationally and from a rehabilitative standpoint;

(b)(13)(ii) lump-sum settlements shall be permitted only for the payment of loss of earnings from work and may be reduced to the present value of net benefit payments computed on the basis of a six percent annual interest factor and any other applicable offsets; and

(b)(13)(iii) no lump-sum settlement shall be permitted unless the form for lump-sum settlement agreement, Appendix 13-A, infra, is executed by the parties specified thereon and approved by an arbitrator or a court of competent jurisdiction in accordance with the provisions of this Subpart.

(c) Other reasonable and necessary expenses sustained. Where the applicant sustains other reasonable and necessary expenses, such services must be actually performed for a charge by a person who is not legally obligated to render them and would not ordinarily perform such services as part of a family relationship; provided, however, that if a member of a family or relative suffers pecuniary loss in order to render such services, such person shall be reimbursed to the extent of the reasonable value of such services.

## Historical note

Sec. filed Aug. 2, 2001 eff. Sept. 1, 2001.

## Decisions citing this section (125)

From the beynensonlaw.com case-law database, grouped by the subdivision cited. Highest court first, then most-cited first. Compiled automatically from the text of the decisions.

### Subdivision (a) (115)

- [State Farm Mut. Auto. Ins. Co. v Mallela (2005 NY Slip Op 02416)](https://www.beynensonlaw.com/case-law/state-farm-mut-auto-ins-co-v-mallela-2005-ny-slip-op-02416/) — Court of Appeals
- [Andrew Carothers, M.D., P.C. v Progressive Ins. Co. (2019 NY Slip Op 04643)](https://www.beynensonlaw.com/case-law/andrew-carothers-m-d-p-c-v-progressive-ins-co-2019-ny-slip-op-04643/) — Court of Appeals
- [Government Employees Ins. Co. v Mayzenberg (2025 NY Slip Op 06527)](https://www.beynensonlaw.com/case-law/government-employees-ins-co-v-mayzenberg-2025-ny-slip-op-06527/) — Court of Appeals
- [One Beacon Ins. Group, LLC v Midland Med. Care, P.C. (2008 NY Slip Op 06813)](https://www.beynensonlaw.com/case-law/one-beacon-ins-group-llc-v-midland-med-care-p-c-2008-ny-slip-op06813/) — Appellate Division, Second Department
- [Allstate Ins. Co. v Belt Parkway Imaging, P.C. (2006 NY Slip Op 07279)](https://www.beynensonlaw.com/case-law/allstate-ins-co-v-belt-parkway-imaging-p-c-2006-ny-slip-op-07279/) — Appellate Division, First Department
- [A.M. Med. Servs., P.C. v Progressive Cas. Ins. Co. (2012 NY Slip Op 06902)](https://www.beynensonlaw.com/case-law/a-m-med-servs-p-c-v-progressive-cas-ins-co-2012-ny-slip-op-06902/) — Appellate Division, Second Department
- [Nationwide Affinity Ins. Co. of Am. v Acuhealth Acupuncture, P.C. (2017 NY Slip Op 08007)](https://www.beynensonlaw.com/case-law/nationwide-affinity-ins-co-of-am-v-acuhealth-acupuncture-p-c-2017-ny-slip-op08007/) — Appellate Division, Second Department
- [Carothers v Progressive Ins. Co. (2017 NY Slip Op 02614)](https://www.beynensonlaw.com/case-law/carothers-v-progressive-ins-co-2017-ny-slip-op-02614/) — Appellate Division, Second Department
- [Liberty Mut. Ins. Co. v Raia Med. Health, P.C. (2016 NY Slip Op 04916)](https://www.beynensonlaw.com/case-law/liberty-mut-ins-co-v-raia-med-health-p-c-2016-ny-slip-op04916/) — Appellate Division, Second Department
- [Country-Wide Ins. Co. v Gotham Med., P.C. (2017 NY Slip Op 07538)](https://www.beynensonlaw.com/case-law/country-wide-ins-co-v-gotham-med-p-c-2017-ny-slip-op-07538/) — Appellate Division, First Department
- [Country-Wide Ins. Co. v Valdan Acupuncture, P.C. (2017 NY Slip Op 04068)](https://www.beynensonlaw.com/case-law/country-wide-ins-co-v-valdan-acupuncture-p-c-2017-ny-slip-op04068/) — Appellate Division, First Department
- [Allstate Ins. Co. v Belt Parkway Imaging, P.C. (2010 NY Slip Op 08783)](https://www.beynensonlaw.com/case-law/allstate-ins-co-v-belt-parkway-imaging-p-c-2010-ny-slip-op-08783/) — Appellate Division, First Department
- [Points of Health Acupuncture, P.C. v Lancer Ins. Co. (2010 NY Slip Op 51338(U))](https://www.beynensonlaw.com/case-law/points-of-health-acupuncture-p-c-v-lancer-ins-co-2010-ny-slip-op51338u/) — Appellate Term, Second Department
- [A.B. Med. Servs. PLLC v Utica Mut. Ins. Co. (2006 NY Slip Op 26068)](https://www.beynensonlaw.com/case-law/a-b-med-servs-pllc-v-utica-mut-ins-co-2006-ny-slip-op-26068/) — Appellate Term, Second Department
- [Lexington Acupuncture, P.C. v State Farm Ins. Co. (2006 NY Slip Op 26251)](https://www.beynensonlaw.com/case-law/lexington-acupuncture-p-c-v-state-farm-ins-co-2006-ny-slip-op-26251/) — Appellate Term, Second Department
- [Multiquest, P.L.L.C. v Allstate Ins. Co. (2007 NY Slip Op 27366)](https://www.beynensonlaw.com/case-law/multiquest-p-l-l-c-v-allstate-ins-co-2007-ny-slip-op-27366/) — Appellate Term, Second Department
- [Lexington Acupuncture, P.C. v General Assur. Co. (2012 NY Slip Op 22047)](https://www.beynensonlaw.com/case-law/lexington-acupuncture-p-c-v-general-assur-co-2012-ny-slip-op-22047/) — Appellate Term, Second Department
- [Metroscan Imaging, P.C. v GEICO Ins. Co. (2006 NY Slip Op 26319)](https://www.beynensonlaw.com/case-law/metroscan-imaging-p-c-v-geico-ins-co-2006-ny-slip-op-26319/) — Appellate Term, Second Department
- [Crossbay Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2007 NY Slip Op 27135)](https://www.beynensonlaw.com/case-law/crossbay-acupuncture-p-c-v-state-farm-mut-auto-ins-co-2007-ny-slip-op-27135/) — Appellate Term, Second Department
- [Midwood Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2007 NY Slip Op 50052(U))](https://www.beynensonlaw.com/case-law/midwood-acupuncture-p-c-v-state-farm-mut-auto-ins-co-2007-ny-slip-op-50052u/) — Appellate Term, Second Department
- [Midborough Acupuncture P.C. v State Farm Ins. Co. (2006 NY Slip Op 26360)](https://www.beynensonlaw.com/case-law/midborough-acupuncture-p-c-v-state-farm-ins-co-2006-ny-slip-op-26360/) — Appellate Term, Second Department
- [Belt Parkway Imaging, P.C. v State Wide Ins. Co. (2010 NY Slip Op 52229(U))](https://www.beynensonlaw.com/case-law/belt-parkway-imaging-p-c-v-state-wide-ins-co-2010-ny-slip-op52229u/) — Appellate Term, Second Department
- [First Help Acupuncture P.C. v State Farm Ins. Co. (2006 NY Slip Op 51043(U))](https://www.beynensonlaw.com/case-law/first-help-acupuncture-p-c-v-state-farm-ins-co-2006-ny-slip-op-51043u/) — Appellate Term, Second Department
- [Andrew Carothers, M.D., P.C. v Progressive Ins. Co. (2013 NY Slip Op 23232)](https://www.beynensonlaw.com/case-law/andrew-carothers-m-d-p-c-v-progressive-ins-co-2013-ny-slip-op-23232/) — Appellate Term, Second Department
- [Radiology Today, P.C. v GEICO Gen. Ins. Co. (2011 NY Slip Op 21161)](https://www.beynensonlaw.com/case-law/radiology-today-p-c-v-geico-gen-ins-co-2011-ny-slip-op-21161/) — Appellate Term, Second Department
- [Five Boro Psychological Servs., P.C. v AutoOne Ins. Co. (2010 NY Slip Op 20131)](https://www.beynensonlaw.com/case-law/five-boro-psychological-servs-p-c-v-autoone-ins-co-2010-ny-slip-op-20131/) — Appellate Term, Second Department
- [Quality Med. Care, P.C. v New York Cent. Mut. Fire Ins. Co. (2010 NY Slip Op 50262(U))](https://www.beynensonlaw.com/case-law/quality-med-care-p-c-v-new-york-cent-mut-fire-ins-co-2010-ny-slip-op50262u/) — Appellate Term, Second Department
- [Devonshire Surgical Facility v GEICO (2007 NY Slip Op 51308(U))](https://www.beynensonlaw.com/case-law/devonshire-surgical-facility-v-geico-2007-ny-slip-op-51308u/) — Appellate Term, First Department
- [Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50196(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slip-op-50196u/) — Appellate Term, Second Department
- [RLC Med., P.C. v Allstate Ins. Co. (2010 NY Slip Op 50642(U))](https://www.beynensonlaw.com/case-law/rlc-med-p-c-v-allstate-ins-co-2010-ny-slip-op-50642u/) — Appellate Term, Second Department
- [Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50836(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slipop-50836u/) — Appellate Term, Second Department
- [Wave Med. Servs., P.C. v Farmers New Century Ins. Co. (2020 NY Slip Op 50555(U))](https://www.beynensonlaw.com/case-law/wave-med-servs-p-c-v-farmers-new-century-ins-co-2020-ny-slip-op50555u/) — Appellate Term, Second Department
- [RLC Med., P.C. v Allstate Ins. Co. (2010 NY Slip Op 51962(U))](https://www.beynensonlaw.com/case-law/rlc-med-p-c-v-allstate-ins-co-2010-ny-slip-op-51962u/) — Appellate Term, Second Department
- [Marc Habif, D.C./Complete Care Chiropractic v Kemper Auto & Home Ins. (2010 NY Slip Op 20219)](https://www.beynensonlaw.com/case-law/marc-habif-d-c-complete-care-chiropractic-v-kemper-auto-home-ins-2010-ny-slip-op-20219/) — Appellate Term, Second Department
- [S & B Neurocare, P.C. v GEICO Ins. Co. (2008 NY Slip Op 51450(U))](https://www.beynensonlaw.com/case-law/s-b-neurocare-p-c-v-geico-ins-co-2008-ny-slip-op-51450u/) — Appellate Term, Second Department
- [Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50306(U))](https://www.beynensonlaw.com/case-law/burke-2-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slip-op-50306u/) — Appellate Term, Second Department
- [62-41 Woodhaven Med., P.C. v Adirondack Ins. Exch. (2011 NY Slip Op 50026(U))](https://www.beynensonlaw.com/case-law/62-41-woodhaven-med-p-c-v-adirondack-ins-exch-2011-ny-slip-op50026u/) — Appellate Term, Second Department
- [Quality Med. Healthcare of NY, P.C. v NY Cent. Mut. Fire Ins. Co. (2010 NY Slip Op 20493)](https://www.beynensonlaw.com/case-law/quality-med-healthcare-of-ny-p-c-v-ny-cent-mut-fire-ins-co-2010-ny-slip-op-20493/) — Appellate Term, Second Department
- [Healthmakers Med. Group, P.C. v Travelers Indem. Co. (2006 NY Slip Op 52118(U))](https://www.beynensonlaw.com/case-law/healthmakers-med-group-p-c-v-travelers-indem-co-2006-ny-slip-op-52118u/) — Appellate Term, First Department
- [Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 51152(U))](https://www.beynensonlaw.com/case-law/burke-2-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slip-op-51152u/) — Appellate Term, Second Department
- [Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50845(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slipop-50845u/) — Appellate Term, Second Department
- [Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50194(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slip-op-50194u/) — Appellate Term, Second Department
- [Parisien v Avis Car Rental, LLC (2023 NY Slip Op 50891(U))](https://www.beynensonlaw.com/case-law/parisien-v-avis-car-rental-llc-2023-ny-slip-op-50891u/) — Appellate Term, Second Department
- [Veraso Med. Supply Corp. v Nationwide Ins. (2021 NY Slip Op 51167(U))](https://www.beynensonlaw.com/case-law/veraso-med-supply-corp-v-nationwide-ins-2021-ny-slip-op-51167u/) — Appellate Term, Second Department
- [Parisien v 21st Century Ins. Co. (2018 NY Slip Op 51081(U))](https://www.beynensonlaw.com/case-law/parisien-v-21st-century-ins-co-2018-ny-slip-op-51081u/) — Appellate Term, Second Department
- [High Quality Med. Supplies, Inc. v Mercury Ins. Group (2016 NY Slip Op 51444(U))](https://www.beynensonlaw.com/case-law/high-quality-med-supplies-inc-v-mercury-ins-group-2016-ny-slip-op51444u/) — Appellate Term, Second Department
- [First Care Chiropractic of NJ, P.C. v Mvaic (2015 NY Slip Op 50677(U))](https://www.beynensonlaw.com/case-law/first-care-chiropractic-of-nj-p-c-v-mvaic-2015-ny-slip-op-50677u/) — Appellate Term, Second Department
- [Physical Performance Testing of NY v New York Cent. Mut. Fire Ins. Co. (2013 NY Slip Op 50581(U))](https://www.beynensonlaw.com/case-law/physical-performance-testing-of-ny-v-new-york-cent-mut-fire-ins-co-2013-ny-slip-op-50581u/) — Appellate Term, First Department
- [VE Med. Care, P.C. v Auto One Ins. Co. (2012 NY Slip Op 50571(U))](https://www.beynensonlaw.com/case-law/ve-med-care-p-c-v-auto-one-ins-co-2012-ny-slip-op-50571u/) — Appellate Term, Second Department
- [Queens Brooklyn Med. Rehab, P.C. v Allstate Ins. Co. (2011 NY Slip Op 52010(U))](https://www.beynensonlaw.com/case-law/queens-brooklyn-med-rehab-p-c-v-allstate-ins-co-2011-ny-slip-op52010u/) — Appellate Term, Second Department
- [RLC Med., P.C. v Allstate Prop. & Cas. Ins. Co. (2009 NY Slip Op 52691(U))](https://www.beynensonlaw.com/case-law/rlc-med-p-c-v-allstate-prop-cas-ins-co-2009-ny-slip-op52691u/) — Appellate Term, Second Department
- [Multiquest, P.L.L.C. v Allstate Ins. Co. (2008 NY Slip Op 51531(U))](https://www.beynensonlaw.com/case-law/multiquest-p-l-l-c-v-allstate-ins-co-2008-ny-slip-op-51531u/) — Appellate Term, Second Department
- [PDG Psychological, P.C. v State Farm Mut. Ins. Co. (2007 NY Slip Op 51757(U))](https://www.beynensonlaw.com/case-law/pdg-psychological-p-c-v-state-farm-mut-ins-co-2007-ny-slip-op-51757u/) — Appellate Term, Second Department
- [Statewide Med. Acupuncture Servs., PC v Travelers Ins. Co. (2005 NY Slip Op 51773(U))](https://www.beynensonlaw.com/case-law/statewide-med-acupuncture-servs-pc-v-travelers-ins-co-2005-ny-slip-op-51773u/) — Trial court
- [Manhattan Med. Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2008 NY Slip Op 51844(U))](https://www.beynensonlaw.com/case-law/manhattan-med-imaging-p-c-v-state-farm-mut-auto-ins-co-2008-ny-slip-op51844u/) — Trial court
- [Metroscan Imaging P.C. v GEICO Ins. Co. (2005 NY Slip Op 25228)](https://www.beynensonlaw.com/case-law/metroscan-imaging-p-c-v-geico-ins-co-2005-ny-slip-op-25228/) — Trial court
- [Dynamic Med. Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2010 NY Slip Op 20285)](https://www.beynensonlaw.com/case-law/dynamic-med-imaging-p-c-v-state-farm-mut-auto-ins-co-2010-ny-slip-op-20285/) — Trial court
- [Matter of Andrew Carothers, M.D., P.C. v Insurance Cos. Represented by Bruno Gerbino & Soriano, LLP (2009 NY Slip Op 29413)](https://www.beynensonlaw.com/case-law/matter-of-andrew-carothers-m-d-p-c-v-insurance-cos-represented-by-bruno-gerbino-soriano-llp-2009-ny-slip-op-29413/) — Trial court
- [Matter of Andrew Carothers, M.D., P.C. v Insurance Cos. Represented by Bruno, Gerbino & Soriano LLP (2006 NY Slip Op 26372)](https://www.beynensonlaw.com/case-law/matter-of-andrew-carothers-m-d-p-c-v-insurance-cos-represented-by-bruno-gerbino-soriano-llp-2006-ny-slip-op-26372/) — Trial court
- [Multiquest, PLLC v Allstate Ins. Co. (2005 NY Slip Op 25356)](https://www.beynensonlaw.com/case-law/multiquest-pllc-v-allstate-ins-co-2005-ny-slip-op-25356/) — Trial court
- [St. Paul Travelers Ins. Co. v Nandi (2007 NY Slip Op 51154(U))](https://www.beynensonlaw.com/case-law/st-paul-travelers-ins-co-v-nandi-2007-ny-slip-op-51154u/) — Trial court
- [Tahir v Progressive Cas. Ins. Co. (2006 NY Slip Op 26149)](https://www.beynensonlaw.com/case-law/tahir-v-progressive-cas-ins-co-2006-ny-slip-op-26149/) — Trial court
- [A.T. Med., P.C. v State Farm Mut. Ins. Co. (2005 NY Slip Op 25461)](https://www.beynensonlaw.com/case-law/a-t-med-p-c-v-state-farm-mut-ins-co-2005-ny-slip-op-25461/) — Trial court
- [Victory Med. Diagnostics, P.C. v Nationwide Prop. & Cas. Ins. Co. (2012 NY Slip Op 22149)](https://www.beynensonlaw.com/case-law/victory-med-diagnostics-p-c-v-nationwide-prop-cas-ins-co-2012-ny-slip-op-22149/) — Trial court
- [Multiquest, PLLC v Allstate Ins. Co. (2005 NY Slip Op 25512)](https://www.beynensonlaw.com/case-law/multiquest-pllc-v-allstate-ins-co-2005-ny-slip-op-25512/) — Trial court
- [CKC Chiropractic v Republic W. Ins. Co. (2004 NY Slip Op 24351)](https://www.beynensonlaw.com/case-law/ckc-chiropractic-v-republic-w-ins-co-2004-ny-slip-op-24351/) — Trial court
- [Eastern Med., P.C. v Allstate Ins. Co. (2008 NY Slip Op 28109)](https://www.beynensonlaw.com/case-law/eastern-med-p-c-v-allstate-ins-co-2008-ny-slip-op-28109/) — Trial court
- [Island Chiropractic Testing, P.C. v Nationwide Ins. Co. (2012 NY Slip Op 51001(U))](https://www.beynensonlaw.com/case-law/island-chiropractic-testing-p-c-v-nationwide-ins-co-2012-ny-slip-op51001u/) — Trial court
- [Brownsville Advance Med., P.C. v Country-Wide Ins. Co. (2011 NY Slip Op 52255(U))](https://www.beynensonlaw.com/case-law/brownsville-advance-med-p-c-v-country-wide-ins-co-2011-ny-slip-op52255u/) — Trial court
- [Neomy Med., P.C. v American Tr. Ins. Co. (2011 NY Slip Op 50536(U))](https://www.beynensonlaw.com/case-law/neomy-med-p-c-v-american-tr-ins-co-2011-ny-slip-op-50536u/) — Trial court
- [Jing Huo Lac v American Tr. Ins. Co. (2008 NY Slip Op 51177(U))](https://www.beynensonlaw.com/case-law/jing-huo-lac-v-american-tr-ins-co-2008-ny-slip-op-51177u/) — Trial court
- [Montgomery Med., P.C. v State Farm Ins. Co. (2006 NY Slip Op 51116(U))](https://www.beynensonlaw.com/case-law/montgomery-med-p-c-v-state-farm-ins-co-2006-ny-slip-op-51116u/) — Trial court
- [Travelers Indem. Co. v Parisien (2020 NY Slip Op 51561(U))](https://www.beynensonlaw.com/case-law/travelers-indem-co-v-parisien-2020-ny-slip-op-51561u/) — Trial court
- [HKP Physical Therapy, P.C. v Government Empls. Ins. Co. (2019 NY Slip Op 29381)](https://www.beynensonlaw.com/case-law/hkp-physical-therapy-p-c-v-government-empls-ins-co-2019-ny-slip-op-29381/) — Trial court
- [H & H Chiropractic Servs., P.C. v Metropolitan Prop. & Cas. Ins. Co. (2015 NY Slip Op 25132)](https://www.beynensonlaw.com/case-law/h-h-chiropractic-servs-p-c-v-metropolitan-prop-cas-ins-co-2015-ny-slip-op-25132/) — Trial court
- [New York Cent. Mut. Ins. v McGee (2009 NY Slip Op 52385(U))](https://www.beynensonlaw.com/case-law/new-york-cent-mut-ins-v-mcgee-2009-ny-slip-op-52385u/) — Trial court
- [AIU Ins. Co. v Deajess Med. Imaging, P.C. (2009 NY Slip Op 29079)](https://www.beynensonlaw.com/case-law/aiu-ins-co-v-deajess-med-imaging-p-c-2009-ny-slip-op-29079/) — Trial court
- [Utica Natl. Ins. Group v Luban (2008 NY Slip Op 52610(U))](https://www.beynensonlaw.com/case-law/utica-natl-ins-group-v-luban-2008-ny-slip-op-52610u/) — Trial court
- [Cambridge Med., P.C. v Nationwide Prop. & Cas. Ins. Co. (2008 NY Slip Op 50629(U))](https://www.beynensonlaw.com/case-law/cambridge-med-p-c-v-nationwide-prop-cas-ins-co-2008-ny-slip-op50629u/) — Trial court
- [Allstate Ins. Co. v Belt Parkway Imaging, P.C. (2006 NY Slip Op 26024)](https://www.beynensonlaw.com/case-law/allstate-ins-co-v-belt-parkway-imaging-p-c-2006-ny-slip-op-26024/) — Trial court
- [Multiquest, P.L.L.C. v Allstate Ins. Co. (2005 NY Slip Op 52071(U))](https://www.beynensonlaw.com/case-law/multiquest-p-l-l-c-v-allstate-ins-co-2005-ny-slip-op-52071u/) — Trial court
- [Multiquest PLLC v Allstate Ins. Co. (2005 NY Slip Op 52209(U))](https://www.beynensonlaw.com/case-law/multiquest-pllc-v-allstate-ins-co-2005-ny-slip-op-52209u/) — Trial court
- [Multiquest, P.L.L.C. v Allstate Ins. Co. (2005 NY Slip Op 52069(U))](https://www.beynensonlaw.com/case-law/multiquest-p-l-l-c-v-allstate-ins-co-2005-ny-slip-op-52069u/) — Trial court
- [American Tr. Ins. Co. v North Shore Family Chiropractic PC (2023 NY Slip Op 50208(U))](https://www.beynensonlaw.com/case-law/american-tr-ins-co-v-north-shore-family-chiropractic-pc-2023-ny-slipop-50208u/) — Trial court
- [Apazidis, M.D., P.C. v State Farm Mut. Auto. Ins. Co. (2021 NY Slip Op 50498(U))](https://www.beynensonlaw.com/case-law/apazidis-m-d-p-c-v-state-farm-mut-auto-ins-co-2021-ny-slip-op50498u/) — Trial court
- [Harvey Family Chiro PT & Acup, PLLC v Ameriprise Ins. Co. (2020 NY Slip Op 20136)](https://www.beynensonlaw.com/case-law/harvey-family-chiro-pt-acup-pllc-v-ameriprise-ins-co-2020-ny-slip-op-20136/) — Trial court
- [Total Chiropractic, P.C. v USAA Cas. Ins. Co. (2017 NY Slip Op 50977(U))](https://www.beynensonlaw.com/case-law/total-chiropractic-p-c-v-usaa-cas-ins-co-2017-ny-slip-op-50977u/) — Trial court
- [NY Rehab Pain Mgt. & Med. Servs., PC v State Farm Auto Ins. Co. (2016 NY Slip Op 50821(U))](https://www.beynensonlaw.com/case-law/ny-rehab-pain-mgt-med-servs-pc-v-state-farm-auto-ins-co-2016ny-slip-op-50821u/) — Trial court
- [Urban Radiology, P.C. v GEICO Ins. Co. (2010 NY Slip Op 51554(U))](https://www.beynensonlaw.com/case-law/urban-radiology-p-c-v-geico-ins-co-2010-ny-slip-op-51554u/) — Trial court
- [Autoone Ins. Co. v Manhattan Hgts. Med., P.C. (2009 NY Slip Op 51663(U))](https://www.beynensonlaw.com/case-law/autoone-ins-co-v-manhattan-hgts-med-p-c-2009-ny-slip-op51663u/) — Trial court
- [Autoone Ins. Co. v Manhattan Hgts. Med., P.C. (2009 NY Slip Op 51662(U))](https://www.beynensonlaw.com/case-law/autoone-ins-co-v-manhattan-hgts-med-p-c-2009-ny-slip-op51662u/) — Trial court
- [A.B. Med. Servs. PLLC v Travelers Indem. Co. (2008 NY Slip Op 28185)](https://www.beynensonlaw.com/case-law/a-b-med-servs-pllc-v-travelers-indem-co-2008-ny-slip-op-28185/) — Trial court
- [Citywide Social Work & Psychological Servs., P.L.L.C. v State Farm Mut. Auto. Ins. Co. (2006 NY Slip Op 51831(U))](https://www.beynensonlaw.com/case-law/citywide-social-work-psychological-servs-p-l-l-c-v-state-farm-mut-auto-ins-co-2006-ny-slip-op-51831u/) — Trial court
- [Proscan Radiology of Buffalo v Progressive Cas. Ins. Co. (2006 NY Slip Op 51242(U))](https://www.beynensonlaw.com/case-law/proscan-radiology-of-buffalo-v-progressive-cas-ins-co-2006-ny-slip-op-51242u/) — Trial court
- [Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. PIP/BI Claims (2026 NY Slip Op 26164)](https://www.beynensonlaw.com/case-law/burke-2-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-pip-bi-claims-2026-ny-slip-op-26164/) — Trial court
- [Renelique v Foremost Signature Ins. Co. (2023 NY Slip Op 51226(U))](https://www.beynensonlaw.com/case-law/renelique-v-foremost-signature-ins-co-2023-ny-slip-op-51226u/) — Trial court
- [Jiang Acupuncture PC v State Farm Ins. Co. (2023 NY Slip Op 50961(U))](https://www.beynensonlaw.com/case-law/jiang-acupuncture-pc-v-state-farm-ins-co-2023-ny-slip-op50961u/) — Trial court
- [State Farm Mut. Auto. Ins. Co. v Emote Med. Servs., P.C. (2022 NY Slip Op 50818(U))](https://www.beynensonlaw.com/case-law/state-farm-mut-auto-ins-co-v-emote-med-servs-p-c-2022-ny-slip-op50818u/) — Trial court
- [Okslen Acupuncture, PC v State Farm Mut. Auto. Ins. Co. (2021 NY Slip Op 50652(U))](https://www.beynensonlaw.com/case-law/okslen-acupuncture-pc-v-state-farm-mut-auto-ins-co-2021-ny-slip-op50652u/) — Trial court
- [Burke Physical Therapy, PC v State Farm Mut. Auto. Ins. Co. (2021 NY Slip Op 50624(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-pc-v-state-farm-mut-auto-ins-co-2021-ny-slip-op50624u/) — Trial court
- [Alsaad Med., P.C. v State Farm Mut. Auto. Ins. Co. (2021 NY Slip Op50532(U))](https://www.beynensonlaw.com/case-law/alsaad-med-p-c-v-state-farm-mut-auto-ins-co-2021-ny-slip-op50532u/) — Trial court
- [Arthur Ave. Med. Servs., PC v GEICO Ins. Co. (2021 NY Slip Op 21108)](https://www.beynensonlaw.com/case-law/arthur-ave-med-servs-pc-v-geico-ins-co-2021-ny-slip-op-21108/) — Trial court
- [Professional Chiropractic Care, P.C. v 21st Century Ins. Co. (2017 NY Slip Op 27380)](https://www.beynensonlaw.com/case-law/professional-chiropractic-care-p-c-v-21st-century-ins-co-2017-ny-slip-op-27380/) — Trial court
- [Downtown Acupuncture PC v State Wide Ins. Co. (2015 NY Slip Op25371)](https://www.beynensonlaw.com/case-law/downtown-acupuncture-pc-v-state-wide-ins-co-2015-ny-slip-op25371/) — Trial court
- [Acuhealth Acupuncture, PC v Country-Wide Ins. Co. (2015 NY Slip Op 51256(U))](https://www.beynensonlaw.com/case-law/acuhealth-acupuncture-pc-v-country-wide-ins-co-2015-ny-slip-op51256u/) — Trial court
- [Avanguard Med. Group, PLLC(b) v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 51940(U))](https://www.beynensonlaw.com/case-law/avanguard-med-group-pllcb-v-state-farm-mut-auto-ins-co-2014-nyslip-op-51940u/) — Trial court
- [Chubb Ins. Co. v GEICO Ins. Co. (2008 NY Slip Op 51985(U))](https://www.beynensonlaw.com/case-law/chubb-ins-co-v-geico-ins-co-2008-ny-slip-op-51985u/) — Trial court
- [One Beacon Ins. Group, LLC v Halima (2008 NY Slip Op 52715(U))](https://www.beynensonlaw.com/case-law/one-beacon-ins-group-llc-v-halima-2008-ny-slip-op-52715u/) — Trial court
- [Multiquest, P.L.L.C. v Allstate Ins. Co. (2007 NY Slip Op 51776(U))](https://www.beynensonlaw.com/case-law/multiquest-p-l-l-c-v-allstate-ins-co-2007-ny-slip-op-51776u/) — Trial court
- [Devonshire Surgical Facility v AIU Ins. Co. (2007 NY Slip Op 51034(U))](https://www.beynensonlaw.com/case-law/devonshire-surgical-facility-v-aiu-ins-co-2007-ny-slip-op-51034u/) — Trial court
- [Devonshire Surgical Facility v Prudential Prop. & Cas. Co. (2006 NY Slip Op 52057(U))](https://www.beynensonlaw.com/case-law/devonshire-surgical-facility-v-prudential-prop-cas-co-2006-ny-slip-op-52057u/) — Trial court
- [Montgomery Med., P.C. v State Farm Ins. Co. (2006 NY Slip Op 51003(U))](https://www.beynensonlaw.com/case-law/montgomery-med-p-c-v-state-farm-ins-co-2006-ny-slip-op-51003u/) — Trial court
- [SK Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 50721(U))](https://www.beynensonlaw.com/case-law/sk-med-servs-p-c-v-new-york-cent-mut-fire-ins-co-2006-ny-slip-op-50721u/) — Trial court
- [Better Health Med. PLLC v Empire/Allcity Ins. Co. (2006 NY Slip Op 50571(U))](https://www.beynensonlaw.com/case-law/better-health-med-pllc-v-empire-allcity-ins-co-2006-ny-slip-op-50571u/) — Trial court
- [563 Grand Med., P.C. v Allstate Ins. Co. (2005 NY Slip Op 50127(U))](https://www.beynensonlaw.com/case-law/563-grand-med-p-c-v-allstate-ins-co-2005-ny-slip-op-50127u/) — Trial court

### Subdivision (b) (4)

- [Sharpe v Allstate Ins. Co. (2005 NY Slip Op 00063)](https://www.beynensonlaw.com/case-law/sharpe-v-allstate-ins-co-2005-ny-slip-op-00063/) — Appellate Division, Third Department
- [Ross v GEICO Indem. Co. (2019 NY Slip Op 04242)](https://www.beynensonlaw.com/case-law/ross-v-geico-indem-co-2019-ny-slip-op-04242/) — Appellate Division, Third Department
- [Freligh v Government Empls. Ins. Co. (2017 NY Slip Op 05911)](https://www.beynensonlaw.com/case-law/freligh-v-government-empls-ins-co-2017-ny-slip-op-05911/) — Appellate Division, Third Department
- [Government Empls. Ins. Co. v Picone (2025 NY Slip Op 06604)](https://www.beynensonlaw.com/case-law/government-empls-ins-co-v-picone-2025-ny-slip-op-06604/) — Appellate Division, Second Department

### Section cited without a subdivision (6)

- [Government Empls. Ins. Co. v Avanguard Med. Group, PLLC (2015 NY Slip Op 01413)](https://www.beynensonlaw.com/case-law/government-empls-ins-co-v-avanguard-med-group-pllc-2015-ny-slip-op-01413/) — Appellate Division, Second Department
- [Quick v State Farm Mut. Auto. Ins. Co. (2024 NY Slip Op 06268)](https://www.beynensonlaw.com/case-law/quick-v-state-farm-mut-auto-ins-co-2024-ny-slip-op-06268/) — Appellate Division, Third Department
- [Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50195(U))](https://www.beynensonlaw.com/case-law/burke-2-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-2025-ny-slip-op-50195u/) — Appellate Term, Second Department
- [Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. PIP/BI Claims (2025 NY Slip Op 50376(U))](https://www.beynensonlaw.com/case-law/burke-physical-therapy-p-c-v-state-farm-mut-auto-ins-co-pip-bi-claims-2025-ny-slip-op-50376u/) — Trial court
- [State Farm Mut. Auto. Ins. Co. v Garden Med. Care, P.C. (2023 NY Slip Op 50762(U))](https://www.beynensonlaw.com/case-law/state-farm-mut-auto-ins-co-v-garden-med-care-p-c-2023-ny-slip-op50762u/) — Trial court
- [Happy Apple Med. Servs., PC v Liberty Mut. Ins. Co. (2021 NY Slip Op 50336(U))](https://www.beynensonlaw.com/case-law/happy-apple-med-servs-pc-v-liberty-mut-ins-co-2021-ny-slip-op50336u/) — Trial court